Facial Surgery

Blepharoplasty (Eyelid Surgery)

Puffy eyes happen to almost everyone at some point, but when they become a chronic problem, puffy eyes and drooping eyelids can become more than a temporary annoyance. There are many reasons a person can have under eye bags, drooping eyelids, and other aesthetic problems of the eye area.

Aging in the eye area can have a huge impact on resting facial expressions, often creating a perpetually tired, bored, or even angry expression. Besides being misleading, a tired appearance in the mirror can be disheartening and have an impact on self-esteem. As a solution to this common problem, our office in Atlanta offers a popular procedure known as blepharoplasty (cosmetic eyelid surgery).

The aging eyelid starts to droop and sag as muscles weaken, skin loses elasticity, and fat starts to press against the thinning skin of the lower eyelids. Blepharoplasty's purpose is to reposition facial fat and remove excess skin for an alert, awake, and youthful expression.

There are two types of eyelid surgery: upper and lower. The two can be performed combined or as standalone procedures. They may also be performed with other procedures such as a brow lift or face lift as part of a comprehensive facial rejuvenation. Lower blepharoplasty is primarily used to address undereye bags and pockets of fat beneath the eye, while upper blepharoplasty is to correct drooping upper eyelids that affect expression and can even affect normal vision.

Blepharoplasty Consultation

Your consultation with the cosmetic surgeons at our Atlanta office will give you valuable information about the procedure and allow you to ask questions and communicate your goals for surgery. You will have your candidacy assessed and get a recommendation for the type of blepharoplasty that would benefit you the most.

You should take advantage of your consultation by preparing specific questions and getting to know our staff. Communication is essential to getting the results you want, so be sure to discuss your goals and concerns.

Blepharoplasty Candidates

Candidates for eyelid surgery are healthy adults with excess skin, drooping skin, or puffy bags of fatty tissue around the eyes. Most patients are interested in blepharoplasty for cosmetic reasons, but there are some conditions that cause the upper eyelid to droop, impairing normal vision. In other instances, aging may lead to malposition of the lower eyelid which can lead to drying of the eyes. Patients should have realistic expectations about the results of the procedure and be aware of the limitations of the surgery.

Blepharoplasty Procedure

Typically, general anesthesia is not necessary for blepharoplasty, although the anesthesia used will be tailored to the patient's comfort level and the type of procedure(s) being performed. If only blepharoplasty is being performed, local anesthesia with oral sedation (or IV sedation for lower eyelid surgery) can be an excellent option, however if combined with other procedures - or if the patient prefers - general anesthesia is used. Eyelid surgery takes about 1-2 hours on average when performed as a standalone procedure.

A lower blepharoplasty is performed through small incisions hidden underneath the lower lashes within the moist lining tissue on the inside of the eyelid. The main goal of this procedure is removing or repositioning excess fat to smooth the area beneath the eyes and achieve a rested, youthful appearance.

Upper blepharoplasty usually involves the conservative removal of skin and fat of the upper eyelid and is performed through small incisions in the upper eyelid.

Scarring is minimal for both techniques, as the incisions are small and hidden within the eyelids and eyelashes. Major complications with blepharoplasty surgery are rare, and the procedure is considered very safe. The experienced surgeons in our Atlanta office make sure to avoid removing too much skin and fat for a very natural appearance and beautiful results.

Blepharoplasty Recovery

The blepharoplasty recovery process is relatively easy, but patients should expect to spend about a week after the surgery focusing on healing. Some patients experience minor side effects like dry eyes and blurred vision temporarily as the area recovers from the surgery. The thin sutures used in the procedure are removed after 7 days, and bruising should be subsiding around that time as well. Any remaining bruising can be disguised with makeup after day 10.

Some swelling will take longer to resolve, but patients will be able to see preliminary results once the bruising disappears. The difficulty of the recovery period will depend on the type of surgery performed (upper, lower or both) and how well post-operative instructions are followed.

Blepharoplasty FAQs

Drooping eyelids can affect quality of life if they interfere with normal vision, though the problem rarely gets bad enough that the procedure is considered necessary. Blepharoplasty to improve vision is sometimes covered by insurance, but it depends on the specific case, and getting reimbursement can be difficult.

Eyelid surgery itself is not designed to treat wrinkles surrounding the eyes, such as “crow's feet”, but the procedure can sometimes improve these wrinkles if performed alongside other anti-aging treatments. Many patients choose to include other treatments like Botox® and laser skin resurfacing in their treatment plans to address all signs of aging in the eye area.

There is no “right age” for eyelid surgery, as patients only need be healthy adults who could benefit from the procedure. Some patients request blepharoplasty in their 30s if they've inherited heavy bags under their eyes. More commonly, patients request blepharoplasty in their 40s and beyond due to aging related changes.

Absolutely. Many patients are interested in combining blepharoplasty with non-invasive facial rejuvenation procedures such as Botox®, fillers, and laser resurfacing procedures. These treatments are often performed at the same time as the surgery. Eyelid surgery can also be combined with other anti-aging surgeries for more dramatic results. Combination procedures are convenient, effective, and can cut down on patient costs.

Dark circles under the eyes can be caused by many different factors, including hollows under the eyes, shadows caused by eye bags, allergies, thin skin, and visible veins. Blepharoplasty can help improve some of these causes of dark circles, but not others.

Nearly every blepharoplasty surgery can be performed on an outpatient basis. Patients will need to have someone drive them home, and ideally stay with them for a day or two to help ease the recovery process.

Some eye creams can help keep aging at bay, but their effectiveness is limited, and they cannot help with drooping eyelids or established bags under the eyes. After a certain point, these products become a waste of money, and surgery is a much more effective long-term solution that can be expensive upfront, but a good value in the long run.

Permanent negative vision changes after blepharoplasty are very rare. However, blurry vision is a fairly common side effect of the surgery, but should fade shortly. Patients who experience persistent blurriness should seek medical attention, although the problem is usually short-lived.

Everyone's pain threshold is different, but discomfort following eyelid surgery should be relatively mild. Pain medications are prescribed for patient comfort, and the healing process is relatively quick, making the overall discomfort fairly minimal.

Some patients are better served by seeking a browlift for heavy, drooping eyelids, as the sagging of the brow can lead to sagging of the upper lids as well. When the problem is caused by excess skin, however, a blepharoplasty is usually a better choice.

Patients & Visitors

Patients & Visitors

Connect With Us

For assistance, ask a Nurse at Emory HealthConnection™ (404) 778-7777 or Find a Physician

This Web site is provided as a courtesy to those interested in Emory Healthcare and does not constitute medical advice and does not create any physician/patient relationship. Also, Emory Healthcare does not endorse or recommend any specific commercial product or service. This Web site is provided solely for personal and private use of individuals accessing this information, and no part of it may be used for any other purpose.